Effect of Vitamin B12 and folic acid supplementation on neuropsychiatric symptoms and immune response in HIV-positive patients

Abstract

Background:Micronutrients such as B12 and folic acid deficiencies are found in higher number in HIV-infected patients.Objective:We conducted a study to examine the effect of Vitamin B12 and folic acid supplementation on neuropsychiatric manifestations, CD4 count, and anthropometric measurements in HIV-positive patients.Materials and Methods:Three different groups of HIV patients, namely, HIV patients with tuberculosis, HIV patients with neuropsychiatric manifestations, and asymptomatic HIV patients with 50 patients in each group were included in the study. Baseline and follow-up CD4 count, anthropometric measurements, neuropsychiatric assessments, Vitamin B12, and folic acid estimation were done.Results:The prevalence of folic acid deficiency was 27.1% in Group I, 31.9% in Group II, and 23.4% in Group III. The prevalence of Vitamin B12 deficiency was 8.16% in Group I, 6.12% in Group II, and 4.16% in Group III. HIV patients with neuropsychiatric manifestations were noted to have the lowest mean mini–mental score. After the supplementation of vitamins, anthropometric measurements, MMSE as well as Hamilton depression scores, improved in all the three groups whereas Hamilton anxiety scores improved only in Group III. The CD4 count also improved in Groups I and II after the supplementation of vitamins.Conclusion:Folic acid deficiency was highest among neuropsychiatric patients. The majority of people who had a folic acid deficiency have shown improvement in their neuropsychiatric assessment scores as well as CD4 count after its supplementation.

Trends and Adaptive Optimal Set Points of CD4+ Count Clinical Covariates at Each Phase of the HIV Disease Progression

“…Many foods naturally contain folate, a B-vitamin, which is needed for cell growth and metabolism [109,110]. Contrary to [33] that it improves the CD4 + count, our data showed that generally a unit increase in the folate was associated with a drop in the CD4 + cell count.…”

“…Previously suggested covariates of the CD4 + count from different clinical categories include the full blood count [20][21][22][23][24][25][26], lipids [27][28][29], sugar [30][31][32], blood chemistry [21,[33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50], and clinical examination measurements [51][52][53][54][55][56][57][58][59][60].…”

An Evaluation to Determine the Strongest CD4 Count Covariates during HIV Disease Progression in Women in South Africa

“…Among other CD4 + count clinical covariates, sodium and calcium levels are affected by dietary conditions [ 35 , 36 ], which can become a potentially important integral part of the HIV treatment process during disease progression. Other blood chemistry components have also been suggested [ 5 , 7 , 33 , 37 – 52 ] including CD4 + count covariates from other clinical platforms such as the full blood count [ 3 , 5 , 53 – 57 ], lipids [ 58 – 60 ], sugar [ 61 – 63 ] and clinical examination measurements [ 2 , 6 , 64 – 71 ]. It then stands to reason that endeavours to deal with the obstacle of expensive CD4 + count diagnostic devices in the past left a long trail of suggested continuous CD4 + count clinical covariates that have potential to be an important integral part of the treatment process during HIV disease progression.…”

Elevated Plasma Vitamin B12 Concentrations Are Independent Predictors of In-Hospital Mortality in Adult Patients at Nutritional Risk

“…Vitamin B12 deficiency is frequently observed in hospitalized patients [ 1 , 2 ] and is associated with conditions such as anemia and neuropsychiatric disorders [ 3 ]. Despite the lack of definitive and clear clinical evidence, vitamin B12 supplementation is diffuse, in particular among elderly patients at nutritional risk, as it is believed to favor strength and appetite recovery and it is known to have some positive effects on mood and neurological functions [ 4 , 5 ], and to protect against cancer [ 6 ] and heart disease [ 7 ] as well, due to its antioxidant properties [ 8 ].…”